Falls among community-dwelling older adults in the Philippines and Viet Nam: Results from nationally representative samples.

Falls are a significant public health issue globally. However, studies with nationally representative samples have yet to be done to understand falls among older adults in the Philippines and Viet Nam. Using a biopsychosocial perspective, this study investigated the prevalence of falls and their associated factors among community-dwelling older adults in these countries. Cross-sectional data were drawn from the baseline survey of the Longitudinal Study of Ageing and Health in the Philippines (2018, N = 4,606) and the Longitudinal Study of Ageing and Health in Viet Nam (2018, N = 4,378). The outcome variables were any falls in the past year. Independent variables included sociodemographic factors (age, sex, education, living in urban areas, living alone, social network size), biophysical factors (vision, chronic conditions, functional impairments, pain locations, insomnia symptoms, sleep medications, grip strength, walking speed, postural control), and psychological factors (depressive symptoms). Descriptive analysis and logistic regression analysis were used to analyze the data. The results showed that 17.7 % and 7.3 % of older Filipino and Vietnamese adults fell in the year before the study. Significant factors associated with the odds of any falls among Filipino older adults were having a higher level of education, living in urban areas, living with others, experiencing more functional impairments, reporting one or more pain locations, and having poor grip strength. In Viet Nam, having more chronic conditions, experiencing more functional impairments, and reporting two or more pain locations were found to be associated with higher odds of any falls. The population in the Philippines and Viet Nam is aging rapidly. Findings from this study are timely in identifying at-risk individuals and preparing for effective fall prevention strategies.

Prevalence, Awareness, Treatment, and Control of Hypertension Among Older Adults in the Philippines.

BACKGROUND: Little is known about the current prevalence and management of hypertension among older Filipinos. To address this gap, we examined the prevalence, awareness, treatment, and control of hypertension, as well as their correlates, among older Filipinos. METHODS: We analyzed a nationally representative survey of Filipinos aged 60 years and older (N = 5 985) in the Philippines. Blood pressure (BP) measurements were taken using a digital BP apparatus. People with hypertension included those with a systolic BP ≥ 140 mmHg or a diastolic BP ≥ 90 mmHg, or those who reported current use of antihypertensive medication. People with undiagnosed hypertension were those who had measured hypertension but had not been diagnosed by a doctor as having hypertension, while people with untreated hypertension were those who had measured hypertension but not taking medication. Among those who were taking antihypertensive medication, respondents with measured hypertension were considered to have uncontrolled BP. RESULTS: Results showed that 69.1% of older Filipinos had hypertension, but only 61.6% of people with hypertension were aware of their hypertension and 51.5% were untreated. Sociodemographic factors, such as age, sex, education, and living arrangements, were significantly associated with hypertension prevalence, hypertension awareness, lack of treatment for hypertension, and/or suboptimal BP control. CONCLUSION: We observed a high prevalence of hypertension among older Filipinos and a relatively low level of awareness and treatment of hypertension among them. While there are government efforts to address the growing prevalence of hypertension in the country, more efforts should be made to bring these government programs to older Filipinos.

Sex differences in the psychometric properties of the Center for Epidemiological Studies-Depression (CES-D) Scale in older Filipinos.

The literature has yet to fully account for sex differences in the symptomatology and measurement of depressive symptoms, especially in developing settings like the Philippines. Thus, we established the factor structure and assessed the reliability of the 11-item version of the Center for Epidemiological Studies-Depression (CES-D) Scale for assessing depressive symptoms in older Filipino men and women. Using cross-sectional data from 5,209 community-dwelling Filipinos aged 60 and above from a nationally representative survey, Confirmatory Factor Analysis (CFA) and methods in Item Response Theory (IRT) were applied to provide complementary insights into the properties of the scale and its individual items. CFA supported the multidimensionality of the scale. The scale is also sex-invariant, but the relationship between the subfactors and the higher-order factor may differ between men and women. In addition, findings from IRT analysis confirmed the overall utility of the CES-D scale, but positively stated items were found to be internally inconsistent with the rest of the scale. The scale is desirably informative for assessing more severe symptoms, although sex differences were found in the precision of individual items. In general, the 11-item CES-D Scale is an adequate multidimensional tool for assessing moderate to severe depressive symptoms in the older population, especially in older men.

Is there compression or expansion of morbidity in the Philippines?

AIMS: This study contributes to previous initiatives examining healthy and active aging in the Philippines. METHODS: We employed the Sullivan method to calculate healthy life expectancy (HLE) and active life expectancy (ALE) using the 2007 Philippine Survey on Aging and the 2018 Longitudinal Study of Ageing and Health. We compared the estimates at two time points, providing evidence of change over time. RESULTS: There was no statistically significant change in the relative proportion of HLE over time for both sexes, suggesting dynamic equilibrium. For men, the increase in life expectancy was mainly an increase in unhealthy state (UHLE). The slight increases in HLE for all ages were not statistically significant. The differences in relative increase in HLE were not statistically significant. HLE for women increased over time, with statistically significant increases at ages 60 and 70 years. ALE declined in all age groups for both sexes, but the decline was statistically significant only among women in their 60s and 70s. There was also a statistically significant decline in the proportion of remaining life in an active state for all ages among both men and women, suggesting an expansion of morbidity. CONCLUSIONS: Findings suggest no evidence of compression of morbidity in the Philippines from 2007 to 2018. The HLE results suggest a dynamic equilibrium, while ALE results indicate an expansion of morbidity. The findings emphasize the need for the government to promote life course interventions that foster healthy choices and conduct further research to understand the factors influencing longevity and active aging in the Philippines. Geriatr Gerontol Int 2022; 22: 511-515.

Older Adults' Loneliness and Social Relationships in the Philippines: Comparison Between Rural and Urban Contexts.

This study compared patterns of association between social relationship measures and levels of loneliness for rural and urban older adults in the Philippines. We analyzed social relationship measures and loneliness scores (UCLA Three-Item Loneliness Scale) of a nationally representative sample of Filipino adults 60 years and older in the baseline survey of the 2018 Longitudinal Study of Ageing and Health in the Philippines (LSAHP) (n=4,704). The loneliness score was slightly higher for rural older adults (5.8) than for their urban counterparts (5.1; p=.0001). A significantly larger proportion of older adults in rural areas (12.7%) lived alone than in urban areas (5.4%; p=.0008). The overall pattern of association between social relationship measures and loneliness scores for the two groups was mostly similar. For both groups, living alone, having less active social involvement, and seeing friends less frequently were related to higher levels of loneliness. Poorer subjective financial well-being (e.g., the perception of considerable difficulty in making ends meet) was also significantly associated with higher loneliness scores. These findings suggest that the prevention of loneliness for older adults in countries in the early stages of population aging such as the Philippines requires a broad range of public health initiatives.

Acceptance of Love and Remarriage Among Older Adults in the Philippines.

Objectives: Later-life re-partnership has been linked to healthy aging, but little is known about Philippine older adults' perception of love and remarriage in older age. Methods: Using two nationally representative surveys on aging in the Philippines, we estimated the proportion of older adults reporting acceptance. Using weighted logistic regression, we assessed sociodemographic and health factors associated with acceptance as well as the relationship of this acceptance with social activity and health behaviors. Results: Only seventeen percent of respondents reported acceptance. Per multivariable analyses, unmarried men and married women reported acceptance, and acceptance was associated with increased social activity and smoking in men, less smoking in women, and more drinking in both genders. Discussion: Most older adults in the Philippines reported love and remarriage in old age as unacceptable. Through these results, we can understand how attitudes toward later-life relationship impact older adults' health and well-being.

Who cares? Provision of Care and Assistance Among Older Persons in the Philippines.

OBJECTIVE: This study aims to examine the provision of assistance among older persons in the Philippines who experience difficulty with activities of daily living (ADLs) or instrumental activities of daily living (IADLs). METHOD: Data for this research are drawn from the 2007 Philippine Study on Aging (PSOA). Cross-tabulations and regression analyses are used to identify who provides assistance to older Filipinos. RESULTS: The study shows that the Filipino family, particularly spouse and daughters, plays an important role in providing assistance to older Filipinos who need help in carrying out functional activities. This provision of caregiving, however, follows a gendered pattern. Specifically, the spouse provides assistance to older men, whereas daughters provide assistance to older women. Grandchildren and noncoresident family members, to some extent, are also active in providing care to older Filipinos. DISCUSSION: The Filipino family remains faithful to its filial duty toward older persons, but who provides care and the way it is provided are likely to change due to the demographic changes and values shifts that have swept the country.

BCL9 and C9orf5 are associated with negative symptoms in schizophrenia: meta-analysis of two genome-wide association studies.

Schizophrenia is a chronic and debilitating psychiatric condition affecting slightly more than 1% of the population worldwide and it is a multifactorial disorder with a high degree of heritability (80%) based on family and twin studies. Increasing lines of evidence suggest intermediate phenotypes/endophenotypes are more associated with causes of the disease and are less genetically complex than the broader disease spectrum. Negative symptoms in schizophrenia are attractive intermediate phenotypes based on their clinical and treatment response features. Therefore, our objective was to identify genetic variants underlying the negative symptoms of schizophrenia by analyzing two genome-wide association (GWA) data sets consisting of a total of 1,774 European-American patients and 2,726 controls. Logistic regression analysis of negative symptoms as a binary trait (adjusted for age and sex) was performed using PLINK. For meta-analysis of two datasets, the fixed-effect model in PLINK was applied. Through meta-analysis we identified 25 single nucleotide polymorphisms (SNPs) associated with negative symptoms with p<5×10(-5). Especially we detected five SNPs in the first two genes/loci strongly associated with negative symptoms of schizophrenia (P(meta-analysis)<6.22×10(-6)), which included three SNPs in the BCL9 gene: rs583583 showed the strongest association at a P(meta-analysis) of 6.00×10(-7) and two SNPs in the C9orf5 (the top SNP is rs643410 with a p = 1.29 ×10(-6)). Through meta-analysis, we identified several additional negative symptoms associated genes (ST3GAL1, RNF144, CTNNA3 and ZNF385D). This is the first report of the common variants influencing negative symptoms of schizophrenia. These results provide direct evidence of using of negative symptoms as an intermediate phenotype to dissect the complex genetics of schizophrenia. However, additional studies are warranted to examine the underlying mechanisms of these disease-associated SNPs in these genes.

Characterization of dicalcium phosphate dihydrate cements prepared using a novel hydroxyapatite-based formulation.

Dicalcium phosphate dihydrate (DCPD) cements are typically prepared using beta-tricalcium phosphate (beta-TCP) as the base component. However, hydroxyapatite (HA) is an interesting alternative because of its potential for reducing cement acidity, as well as modulating cement properties via ionic substitutions. In the present study, we have characterized DCPD cements prepared with a novel formulation based on monocalcium phosphate monohydrate (MCPM) and HA. Cements were prepared using a 4:1 MCPM:HA molar ratio. The reactivity of HA in this system was verified by showing DCPD formation using poorly crystalline HA, as well as highly crystalline HA. Evaluation of cements prepared with poorly crystalline HA revealed that setting occurs rapidly in the MCPM/HA system, and that the use of a setting regulator is necessary to maintain workability of the cement paste. Compressive testing showed that MCPM/HA cements have strengths comparable to what has previously been published for DCPD cements. However, preliminary in vitro analysis of cement degradation revealed that conversion of DCPD to HA may occur much more rapidly in the MCPM/HA system compared to cements prepared with beta-TCP. Future studies should investigate this property further, as it could have important implications for the use of HA-based DCPD cement formulations.

Rural versus suburban primary care needs, utilization, and satisfaction with telepsychiatric consultation.

CONTEXT AND PURPOSE: Rural and suburban populations remain underserved in terms of psychiatric services but have not been compared directly in terms of using telepsychiatry. METHODS: Patient demographics, reasons for consultation, diagnosis, and alternatives to telepsychiatric consultation were collected for 200 consecutive, first-time telepsychiatric consultations at rural and suburban clinics. FINDINGS: Rural patients were more likely than suburban patients to be younger than 18 years, using Medicaid, and needing treatment planning (lest they be referred out of the community). Rural patient and primary care physician satisfaction was higher than that of suburban counterparts. CONCLUSION: Telepsychiatry programs may enhance access, satisfaction, and quality of rural care.

Hallazgos ecocardiográficos en pacientes geriátricos con soplo sistólico / Echocardiographic findings in geriatric patients with systolic murmurs

Se realizó un estudio retrospectivo analizando los ecocardiogramas de 50 pacientes mayores de 60 años con soplo sistólico y se comparan con 50 pacientes entre 40-60 años en el Hospital Regional Universitario José María Cabral y Báez, Santiago, República Dominicana. Durante el período enero-agosto, 1991. Se evidencia una mayor probabilidad de tener alternaciones cardiológicas en los mayores de 60 años (3.5 veces más). El engrosamiento valvular y la dilatación de cavidad ocupan los hallazgos más frecuentes en los pacientes mayores de 60 años, aunque sin diferencia significativa respecto a los menores de 60 años. Encontrándose de significancia estadística el engrosamiento del septum, esclerosis valvular aórtica hipertrofia del ventrículo izquierdo y el engrosamiento de cavidad. Se concluye que también en los pacientes ancianos con soplo sistólico se debe realizar una evaluación del mismo, siendo el ecocardiograma el procedimiento más inocuo y menos agresivo. Ecocardiografía, soplo sistólico, cardiopatía, anciano, válvulas, cavidades, septum ventrículo